Patient payment system and method for the real-time prevention of healthcare claim adjudication circumvention in all 100% copay situations
US11244767B1 · kind B1 · utility
Inventors
Key dates
| Filing date | Oct 12, 2018 |
| Grant date | Feb 8, 2022 |
| Priority date | — |
| Expiry date | Apr 23, 2040 |
Classification
- Technology area (CPC G)Physics
- CPC primaryG16H40/20
- WIPO fieldIT methods for management
- WIPO sectorElectrical engineering
Abstract
Computerized method requiring claim adjudication to receive patient payment for a product or service provided by a healthcare provider to a patient with full financial responsibility, including receiving a patient claim; re-pricing the claim, automatically initiating a real-time payment authorization request through a payment gateway; receiving a real-time notification that the patient's funding source has verified funds availability, with the funds to be deposited in a designated account for subsequent provider payment; sending the healthcare provider the copay and plan pay pricing edits; and concurrently, sending the patient a payment e-receipt electronically, indicating the total amount due and the amount debited from the patient's funding source, the plan payment, with any difference the copay to be paid directly to the provider. Automatic real-time patient audit enabling payment e-receipts indicate claim adjudications and claim reversals as well as adjudicated copay and plan pay amounts, with the plan payment eliminating adjudication circumvention.
Source: USPTO / EPO open patent data. Objective bibliographic and citation counts.